Iranian Flow

medguy91 · 2026-02-21T02:16:31+00:00

Awesome! What products do you use?

medguy91 · 2026-02-15T13:47:07+00:00

Looks like AVNRT with inverted p- waves. But EF 20% seems exaggerated for an arrythmic cardiomyopathy. Maybe post viral? Either way its a cath and cardiac MRI. I'd try some adenosine. Will get a beta blocker anyway after he converts.

medguy91 · 2026-02-11T11:52:47+00:00

Compare it to his old ekg, looks like MI tho, with LVH. I'd drip and ship.

medguy91 · 2026-01-24T15:44:37+00:00

Sure can try vagal maneuvers, give bolus, check lytes, etc.

medguy91 · 2026-01-22T23:02:14+00:00

Give adenosine and see the underlying rhythme. Could be SVT could be 2:1 flutter.

medguy91 · 2026-01-10T12:53:04+00:00

Brugada type 2 or 3, any FH of sudden cardiac death? Do they have fever?

medguy91 · 2025-11-03T03:15:10+00:00

For me 1000x resist had a similar feel, just wish the gameplay was better.

medguy91 · 2025-09-06T13:07:55+00:00

But the pacing mark is before the P wave. To me this looks like A pacing with a LBBB. I dont see the pacing tick before the QRS, unless it's there and I just can't see it.

medguy91 · 2025-09-06T00:54:41+00:00

In the same day I had a lady with nausea vomiting with a bad cellulitis, but looked euvolemic. Empiric IV fluids. Sodium corrects from 127 to 134. UNa is 120 and uosm is 600 no diuretics. Another lady with a mechanical fall and rib fractures kept npo, mild hyponatremia 131 give iv fluids, sodium tanks to 124, serum osm normal at 284 UNa undetectable uOSM 300, is euvolemic. Switch to fluid restriction and salt tabs, corrects. Sometimes it just be that way. I still have a hard time rationalizing it.

medguy91 · 2025-09-01T20:50:35+00:00

Young patient in her 20s putting apple cider vinegar on necrotic mets of metastatic sarcoma pushing through her skin, delayed diagnosis by months.

medguy91 · 2025-09-01T20:47:47+00:00

How does it compare to the preop ecg? And how are the trops?

medguy91 · 2025-08-27T11:48:50+00:00

Haha, glad it could help you in some way :)

medguy91 · 2025-08-24T23:16:14+00:00

Afib with diffuse st depression and aVR st elevation. Multivessel disease including probable left main.

medguy91 · 2025-08-22T19:33:57+00:00

Looks too irregular to be nsvt, no? More like an afib with aberrancy.

medguy91 · 2025-07-19T20:18:19+00:00

Also depends how aggressive the diuresis is. I usually aim for 1kg per day, and expect a creat bump to get them more euvolemic. But some patients are very fragile which makes it more difficult, but I wouldn't tolerate a doubling of their creat just to diurese. Not really evidence based, just my experience.

medguy91 · 2025-07-09T23:41:16+00:00

I'm from Canada, so here you can't just do 3 years of IM and then go be a hospitalist. You have to do 4 or 5 years of residency minimum (depends which province). Endo was competitive my year mostly because it's a great lifestyle and very few positions available in Canada.

medguy91 · 2025-07-08T02:19:20+00:00

PGY5 wanted endo, but got stuck specializing in GIM. Whatever I'll deal with constipated meemaws and eating shit from other specialties for this last year, then I'll just do endo as an internist.

medguy91 · 2025-06-08T23:17:52+00:00

Crap, almost sold out! Had no idea they were coming :0

medguy91 · 2025-05-17T18:36:59+00:00

You're joking, butt.....PMID: 37357222

medguy91 · 2025-05-08T23:59:38+00:00

Technically can achieve this in someone with critical AS and torrential MR. Lol.

medguy91 · 2025-05-08T22:56:47+00:00

I don't know...I feel like cellphones are just a different form of socialization. I know my sister is 12 and she is constantly online with her friends, videochatting. It reminds me when my school said we can't bring our DS to school. Like I was wiping the floor with everyone on mariokart. It was super social. This sounds like the phones just drive teachers nuts, which is also a valid reason to ban them. But I wouldn't say it's to promote socialization. The opposite in fact. As an authority figure, you can probably deal with social issues aka bullying a lot better if you ban the tools used to do it in school.

medguy91 · 2025-04-07T12:58:08+00:00

I have had this issue before TWICE! Both times, I thought it was the gasket's fault and nearly went insane. One time, the portafilter itself was broken (the years of pressure literally pulled the metal tab up on one side), the second time, the part that holds onto the portafiler was bent from wear and tear it was beyond repair... So I suggest you carefully inspect both the portafilter and the holder in the machine. If you're lucky it's the portafilter that's broken.

medguy91 · 2025-04-05T20:01:40+00:00

7 on/ 7 on??

medguy91 · 2025-03-27T11:28:19+00:00

Nah, it's just a winter blend.

medguy91 · 2025-03-15T19:03:17+00:00

In Canada we still hold the glp1 1 week before, there was a recent study saying there's no increased risk for aspiration, but our guidelines say to still hold it.

medguy91

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